Site troubles create slow start to health care reform in Wisconsin

Dec. 6, 2013

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Gannett Wisconsin Media Investigative Team

Special report

The Affordable Care Act will touch nearly every American. Gannett Wisconsin Media is examining the most important issues in a series called “Health Care Reform & You.” The stories focus on helping you understand what you need to do, how to do it and how to get help. Installments mostly appear on Sundays and Mondays, but we’re also reporting on related news developments as they happen. ONLINE: Click on www.wausaudailyherald.com/healthcarereform for past stories and videos and other information about the changes.

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For the past two months, AyLee Her started most workdays with an error message on his office computer.

Her is a certified insurance application counselor at Bridge Community Health Clinic in Wausau. He began work in mid-September, in preparation for the Oct. 1 launch of the online marketplace where people could buy health insurance.

But at the clinic, and at numerous other places across Wisconsin and the country, things didn’t go as planned.

As a result, President Barack Obama spent October and November promising to fix the website central to his signature initiative: the Affordable Care Act or Obamacare.

Recent improvements have helped, and Her expects to spend the month of December catching up on delayed appointments of people hoping to enroll.

“It seems like everybody waited for the website to be available, so we’re getting an influx now,” Her said.

As the website problems dragged on, insurers and enrollment counselors went low-tech, using face-to-face seminars or question-and-answer sessions to spread the word.

“We didn’t have a goal we wanted to have enrolled (by now), but we certainly had no clue this was going to be how these last two months have gone,” said Abbey Lading, organizer of the regional enrollment network in Brown, Door, Marinette, Oconto and Shawano counties.

During the exchange’s first month, fewer than 900 Wisconsinites chose a plan. Nationally, about 106,000 people did so.

Most exchanges set up by states have fared better than those relying on the federal exchange. Wisconsin Gov. Scott Walker decided against forming a state exchange. So, residents hoping to receive federal subsidies toward their insurance premiums must shop on the federal site, healthcare.gov.

An estimated 550,000 Wisconsin residents — about 18 percent of the population — didn’t have insurance before the Affordable Care Act. The law could cut that number in half, according to the nonpartisan Kaiser Family Foundation, which analyzes health-related issues.

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Improvement noticed

Counselors in Wisconsin who are helping people enroll say the healthcare.gov site has vastly improved in recent weeks.

Molly and Jim Berens tried to set up an account at midnight on Oct. 1 with no luck, but got through in mid-October. The couple, who live in Rothschild, needed to buy insurance after retiring this year.

Molly Berens said she felt “very fortunate” to have an account set up on the federal exchange as other people still struggled with technical issues two weeks into the launch.

The central Wisconsincouple was still comparing plans in late November, trying to decide between plans with a higher deductible or higher out-of-pocket expenses.

“We were shopping for insurance on our own, off the exchange (before), and I can say that it’s much better with the Affordable Care Act,” Jim Berens said.

At Partnership Community Health Center in Menasha, five application counselors helped people complete applications by phone or on paper as the website remained broken in October and November.

Trish Sarvela, the center’s development director, said the technical problems “were a real surprise” to staff members.

Now they’re pleased with the improvements that rolled out this month and encourage people to try enrolling again. The website moves faster and customer service representatives available by live web chat or by phone are better informed than two months ago, Sarvela said.

“One application counselor told me (on Dec. 3) she was able to get somebody through the entire process in 15 minutes over the phone,” she said.

Critical month ahead

The first few weeks of December are “critical” for people who need coverage to start Jan. 1, said Steve Olson, director of the regional enrollment network for Fond du Lac, Ozaukee, Walworth, Washington and Waukesha counties. People must enroll by Dec. 23, an extension of the original Dec. 15 deadline.

Enrollment continues until March 31 for people who don’t need coverage at the start of 2014.

Mary Testin, director of the regional enrollment network for Langlade, Marathon, Oneida and Portage counties, has volunteers going door-to-door in low-income areas and has spent a few nights each month sitting in libraries, waiting to help people fill out applications or answer questions.

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Kathy Donahue is one of six certified application counselors at Agnesian HealthCare in Fond du Lac. She’s been able to help three people purchase insurance on the exchange since Oct. 1, but expects to see a rush of people in December.

Already, she spends a lot of time explaining basic insurance terms such as deductible or co-share.

“When they get to the enrollment process, I just want them to breathe in and out a little and really explain their options,” Donahue said.

Enrollment climbs

After five full weeks of open ACA enrollment, Her, the Wausau application counselor, had successfully helped only one person enroll through the federal website.

Two weeks later, he’d helped 13 more people enroll. He also spent a morning cheerfully explaining the Affordable Care Act to a group of skeptical farm owners and employees perched on folding chairs in a small room at the Athens Village Hall, about 30 miles from Wausau.

Sam Zimmermann sat against a wall, listening to the presentation. His wife provides insurance for their family of six through her job for a bank in Wausau, while he works their dairy farm in the town of Easton. He intends to remain on her plan for the near future.

Zimmermann, 35, can see parts of the law will help people with preexisting conditions. His family has a history of kidney problems that could have cost him on the individual insurance market.

But he’s skeptical of the subsidies for premiums available to most people making between 138 percent and 400 percent of the federal poverty level.